Oh, those high heels

Madeline Barrios has spent almost half her life in high heels. But it wasn’t until late last year that her feet hurt more than the common ache.

“It felt like sharp pains,” said 40-year-old Barrios, adding that her toes would often cramp. “It wouldn’t go away until I took a hot shower.”

In some moments, the soreness was normal, tolerable. But over time, the pain got worse and it didn’t stop even after she slipped off her shoes and took ibuprofen. Then last fall, a podiatrist diagnosed the constant pain in the balls of her feet as bunions, a bony bump that formed at the base of her big toes.

The bones in the front of her foot had expanded and her big toe dislocated — a possible result of poor genes and working eight- to 10-hour days in her two- and three-inch heels. Her bunions, her doctor said, could only be fixed with surgery.

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“When the doctor mentioned ending up with arthritis, I thought I need to do this and get it over,” Barrios said of the surgery, which she had earlier this month. “That’s kind of what did it. I can’t imagine having arthritis. The pain I’m sure would be a lot worse.”

Regular use of high heels — stilettos, pumps and wedges, among others — are one of the biggest contributors of foot problems for women. The shoes, yes, can transform outfits and bring you to the podiatrist quickly with bunions, hammertoe, neuromas and tears in the Achilles tendon.

“Especially since we live in South Florida, we have a lot of patients who are women that have complaints associated with their high heel usage,” said Jaime Carbonell, a board certified podiatrist at Jackson South Community Hospital. “Typically women that wear over three-inch heels, they experience more problems than the rest of the community.”

Although Barrios didn’t always sport three-inch heels, her bunions were severe. She was also genetically predisposed to the condition — her mother had one.

The exact cause of bunions isn’t clear, but heredity and arthritis have been said to play a part. The deformity can also get worse by wearing poorly fitted shoes, like pumps or flats with a narrow toe box that can squish toes into unnatural positions. Heels can exacerbate the problem as they force your body weight onto the front of your foot, placing strain on your toe joints.

“The bunion develops because the bones open up basically,” said Yanira Salas-Stuart, a podiatrist at Memorial Regional Hospital in Hollywood. “People think the bone is growing bigger, but it’s dislocating so it comes out of place.”

Some less severe bunions can be managed with fitted orthopedic soles, but they can become worse and more painful. To avoid the issue, podiatrists suggest selecting shoes that conform to your foot and not a pair that feels too tight.

“Try to find shoes that have cushion in the ball of the foot,” Salas-Stuart says. “In terms of height, have some shoes that you can use and change. In terms of the heels, if they could be wider, they’re more stable.”

Beyond bunions, many other foot issues plague the rooms of podiatrists, like heel pain in the Achilles tendon. Overuse of the tendon behind your heel, which connects the calf muscles at the back of the lower leg to your heel bone, can result in weakness and tears.

Just imagine putting a cinnamon stick in water for six months — the cinnamon stick will become soft and it will break, Salas-Stuart said.

“That’s the same thing that happens with the Achilles tendon,” she said, adding that women “are in high heels all day so their tendon is contracted. Every time they go a little bit lower in shoes, like not such a high heel, the tendon stretches and it will pull a lot more. It starts breaking.”

The back and forth between high heels and bare feet, flip-flops or sandals can result in constant dull pain and potential tearing. Salas-Stuart suggests taking oral anti-inflammatory medicine and ice for the first 72 hours to relieve soreness. Epsom salt in warm water can also help.

“Early intervention is key. Let pain be your signal to get evaluated,” Carbonell said. “If the shoes cause you pain, limit the use of the shoe.”

Other common foot issues for women include hammertoe, a distortion that causes the second toe to bend and become “claw-like” instead of pointing forward; neuromas, a benign growth of tissue between the third and fourth toe that can result in a numbness and tingling; and capsulitis, the swelling of the ligaments around the toe joints.

“We recommend seeing a podiatrist when you notice pain or you see a deformity in your foot,” Carbonell said. “If you wait too long sometimes the solution can be more invasive or surgical.”